Window To The Womb

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that people and communities were always at the centre of how care was planned and delivered. We also looked for evidence that people could access care in ways that met their personal circumstances and protected equality

characteristics. At our last assessment, we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The service made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

All women who attended the clinic were required to complete a booking form in advance of their scan appointments. This ensured staff were fully aware of the health needs of the women and any further information that the service needed to know about them. The service was therefore able to identify each woman's individual needs. Staff gave several examples of how they have contacted women following review of their booking form to discuss their needs further, to ensure the service they received was personal to them. This includes offering additional appointment time slot for women who had anxiety or if English was not their first language and needed further emotional support or translation services.

The service website included information on the scans offered, frequently asked questions (FAQs) and a pregnancy blogs section. The blog section included key information such as early pregnancy, parenting, pregnancy and birth, understanding respiratory syncytial virus (RSV), postpartum mental health resources and introducing newborns to your pets. This empowered women and their loved ones to make their own decisions about their care, health, parenting and lifestyle choices.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had established an effective working relationship with local NHS providers, emergency care services and midwifery services to deliver joined-up and flexible care to women. The service had a referral pathway in place with local hospitals for women who experienced conditions such as ectopic pregnancies, where key information and outcomes regarding pregnancy conditions were shared between services.

The service had flexible opening hours and was able to accommodate the availability of people in the local community when women booked appointments, including evening and weekend availability.

The service had considered the specific needs of women in the local communities, including those with disabilities. The service had trained multidisciplinary staff on how best to address the needs of people who accessed the service. For example, we saw that staff had completed the Oliver McGowan Mandatory Training on Learning Disability and Autism.

The clinic provided a cosy and well-furnished waiting area that offered a comfortable, relaxing and suitable environment for women. The service had accessible toilets and baby changing facilities for women. The clinic was located close to public transport links, and there was free on-site street parking, which supported ease of access. The electronic booking system was monitored daily by clinic managers, offering women the flexibility to book appointments online via a 24/7 platform or by contacting the customer service telephone line from 9am to 5.30pm.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information governance systems included the confidentiality of women’s records. The service complied with the Accessible Information Standard. The information leaflet could be provided in a form accessible to meet the needs of client groups, for example, in easy-read form.

Staff made information leaflets available in languages spoken by women who accessed the service.

Staff ensured that women could obtain information on available scans offered at the clinic, local services, women’s rights, how to complain and so on.

Staff engaged with women and their loved ones in an open and supportive manner. They provided available information clearly on their website and face to face and responded to questions honestly. Staff made use of other accessible methods of communication wherever possible. For example, they used an electronic pad and paper to facilitate communication when needed for a woman with communication difficulties, and they used various interpreters and translation mediums for women who do not speak English.

Staff had up-to-date contact details for local NHS hospitals and fetal medicine units if women had any concerns prior to or during their appointment at the clinic or needed to be signposted to their local hospital. The service signposted women to other agencies where required for further advice and support.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service provided clear information on how women and their loved ones could raise concerns or make complaints. The clinic also displayed information in reception areas explaining how to raise a concern. Women were encouraged to raise any issues initially with staff or the clinic manager.

Women we spoke to knew how to complain or raise concerns. When women complained or raised concerns, they received feedback.

Managers investigated complaints and actively identified themes and trends. Where issues were identified, managers acknowledged the feedback and contacted the women to seek a resolution.

Staff protected women who raised concerns or complaints from discrimination and harassment. Staff knew how to handle complaints appropriately. Staff discussed feedback received during their staff meeting and received feedback on the outcome of investigation of complaints and acted on the findings.

In the past 12 months, the service had received a total of 11 complaints. These were mainly related to image quality (27%) and appropriately cancelled scans (27%). Cancelled scans were due to a recent scan having already been completed, an NHS routine scan not yet having been undertaken, or the client being under 16 years of age.

No complaints were upheld in the last 12 months. At the time of the assessment, the service did not have a backlog of complaints.

The service had an up to date complaints policy, which included contact details for an independent third-party organisation, allowing women to escalate concerns if they remained dissatisfied with the service's response. This aligned with best practice for complaints escalation within independent healthcare services.

The service made sure that people could access the care, support and treatment they needed when they needed it. However, some women experienced delays for their scan appointment.

Staff made reasonable adjustments for women – for example, people with mobility issues had step-free access to the clinic and accessible toilets.

There was an option for women to book same-day appointments online if there were available slots remaining, therefore ensuring a range of flexibility with appointment times. There was step free access to accommodate people with mobility limitations.

However, during the assessment, we observed the clinic was busy during the evening appointments for gender scans and 2 women experienced delays before their scans. One woman waited 55 minutes for her scan, while the other waited 25 minutes.

During this period, we observed that the scan assistant and leaders were not proactive in supporting the sonographer to prepare the scan room between appointments, such as cleaning and preparing the room for the next client. This may have contributed to the delays, as the sonographer was completing scan reports while also preparing for the next appointment.

We escalated our concerns to the service leaders during the assessment. Leaders told us the delays occurred because 3 women attending for gender scans were initially unable to determine their baby’s gender due to the baby’s position. These women were asked to go for a walk and return later to be rescanned between other appointments.

Staff told us they had informed women about the reason for the delays, and that the women were happy to wait. Staff also said that although this does not occur frequently, women are advised during the booking process and on arrival that delays may occur in these circumstances. Women and their loved ones we spoke with told us they were happy to wait and did not mind going for a walk to help determine their baby’s gender.

The service did not audit the waiting time for women. Staff told us women were generally seen on time. However, any delays will be related to rescanning of women who came for a gender scan or if women had to wait in the reception whilst staff provided support and delivered bad news for women who may have experienced a miscarriage or ectopic pregnancy in the scan rooms. Staff told us that gender scans are normally booked later in the evening and appointments were staggered, with women given a 20-minute time slot to help manage flow and minimise delay.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service promoted a culture in which women accessing the service felt empowered to give their views.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff are trained in equality, diversity, inclusion and human rights. Staff we spoke to could explain how they embedded equity into their daily practice to ensure care was equitable and made without discrimination, including in relation to protected characteristics.

Service data showed that staff had received training on LGBTQ+ to raise awareness and on how to best support this client group.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their lives.

The service provided women with information on the various scans they offered at the point of booking and their limitations which supported them to make informed decisions about their care and scan choice.

Staff had a daily briefing meeting at the start of each clinic to discuss the scan cases they had. This ensured all relevant multidisciplinary staff were involved in planning the care of women, including those with additional needs.

The website and scan reports included relevant information leaflets about the pregnancy journey and health promotions to help women make informed decisions about their future.

Staff demonstrated a caring, compassionate and personalised approach to care delivery. Many women chose to remain in contact with the clinic after their scan appointments and shared photographs of their scans, pregnancy journey and babies with staff via the clinic social media pages. This reflected a strong rapport with staff and women using the service.